2023 Mission Evansville Group Leader Registration. Due March 6.
This form is to register a new group. Individual registrations will be submitted separately.

1 adult participant is required for every 3 youth.

Payments can be made as follows:
Initial Deposit - $75 per person (non-refundable) due with parish group registration by Monday, March 6.
Balance and Individual Registrations are due Friday, April 14.
Please make your check out to "Diocese of Evansville", memo Mission Evansville. Your check will need to be received at the address below within 14 days of your group registration or we will release your spaces.

Cindy Shoulders
Mission Evansville
5779 Epworth Road
Newburgh, IN  47630

Registration Questions - contact Cindy Shoulders
phone: 812-453-6130
e-mail: cshoulders11@gmail.com

Please attend our Group Leader meeting on Thursday, March 23, 6:30 PM to receive the Pre-Trip Planning Packet.

THIS FORM IS FOR ADULT CONTACT LEADERS ONLY. INDIVIDUAL REGISTRATIONS ARE NOT ACCEPTED.


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Contact Leader First Name *
Contact Leader Last Name *
Church *
Email *
Mailing Address *
City, State, Zip Code *
Primary Phone Number *
Secondary contact leader and email address
Has your church attended a work camp before? *
Required
If yes, what was the name of the camp?
How many YOUTH spots (ages 14-18 & in high school) do you want to reserve? *
How many YOUNG ADULT spots (ages 18 & graduated - 24) do you want to reserve?
Adults ages 18+ & graduated from high school are required to complete Safe Environment training & a background check.
How many ADULT spots (ages 25+) do you want to reserve? *
REMEMBER we require 1 adult for every 3 youth. Adults need to be 25+ years old and successfully completed Safe Protection training and background check.
Are you available to come to the Group Leader meeting on Thursday, March 23 at 6:30 PM to receive the Pre-Trip Planning Packets for your participants? *
Can we add you to a GroupMe Text thread for contact leaders? *
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